External beam radiotherapy for clinically node-negative, localized hormone-refractory prostate cancer: Impact of pretreatment PSA value on radiotherapeutic outcomes

被引:20
作者
Akimoto, T
Kitamoto, Y
Saito, JI
Harashima, K
Nakano, T
Ito, K
Yamamoto, T
Kurokawa, K
Yamanaka, H
Takahashi, M
Mitsuhashi, N
Niibe, H
机构
[1] Gunma Univ, Grad Sch Med, Dept Radiat Oncol, Gunma 3718511, Japan
[2] Gunma Univ, Grad Sch Med, Dept Urol, Gunma, Japan
[3] Kiryu Kosei Gen Hosp, Dept Radiol, Kiryu, Gumma, Japan
[4] Tokyo Womens Med Univ, Dept Radiol, Tokyo, Japan
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2004年 / 59卷 / 02期
关键词
hormone refractory; prostate cancer; radiotherapy; prostate-specific antigen;
D O I
10.1016/j.ijrobp.2003.10.033
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To analyze the results of clinically node-negative, localized hormone-refractory prostate cancer treated with external beam radiotherapy (EBRT) and to investigate the potential prognostic factors that influenced the therapeutic outcome. Methods and Materials: Fifty-three patients who had developed localized hormone-refractory prostate cancer were treated with EBRT between 1994 and 2001. According to the 1992 American Joint Committee on Cancer clinical stage, 4 patients had T2 and 49 had T3 at the start of RT, and 14 patients had a Gleason score <7, 14 had a Gleason score of 7, and 23 had a Gleason score of 8-10. All patients were treated with EBRT using the unblocked oblique four-field technique, with a total dose of 69 Gy. The fraction dose was 3 Gy three times weekly. The median follow-up after RT was 35 months (range, 8-96 months) and after androgen ablation was 73 months (range, 42-156 months). Results: Of 53 patients, 15 patients subsequently developed clinical relapse, including locoregional and/or distant metastases. The site of first relapse was bone metastasis in 10, lymph nodes in 3, and local failure in 2 patients; 3 patients died of prostate cancer during the analysis period. The 3-year and 5-year cause-specific survival rate was 94% and 87%, respectively, and the 3-year and 5-year clinical relapse-free survival rate was 78% and 56%, respectively. The univariate analysis revealed that a short prostate-specific antigen (PSA) doubling time and high PSA value at the start of RT and a high Gleason score were statistically significant factors for the risk of clinical relapse. Multivariate analysis demonstrated that the PSA value (PSA <= 15 vs. >= 15 ng/mL) at the start of RT was an independent prognostic factor. Conclusion: EBRT could be a treatment of choice for clinically node-negative, localized, hormone-refractory prostate cancer. (C) 2004 Elsevier Inc.
引用
收藏
页码:372 / 379
页数:8
相关论文
共 32 条
[1]   Estimation of the incidence of late bladder and rectum complications after high-dose (70-78 Gy) conformal radiotherapy for prostate cancer, using dose-volume histograms [J].
Boersma, LJ ;
van den Brink, M ;
Bruce, AM ;
Shouman, T ;
Gras, L ;
te Velde, A ;
Lebesque, JV .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1998, 41 (01) :83-92
[2]  
Brenner DJ, 2002, INT J RADIAT ONCOL, V52, P6
[3]   Fractionation and protraction for radiotherapy of prostate carcinoma [J].
Brenner, DJ ;
Hall, EJ .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1999, 43 (05) :1095-1101
[4]   Involvement of PI3K/Akt pathway in cell cycle progression, apoptosis, and neoplastic transformation: a target for cancer chemotherapy [J].
Chang, F ;
Lee, JT ;
Navolanic, PM ;
Steelman, LS ;
Shelton, JG ;
Blalock, WL ;
Franklin, RA ;
McCubrey, JA .
LEUKEMIA, 2003, 17 (03) :590-603
[5]  
COX DR, 1972, J R STAT SOC B, V34, P187
[6]   TOXICITY CRITERIA OF THE RADIATION-THERAPY ONCOLOGY GROUP (RTOG) AND THE EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER (EORTC) [J].
COX, JD ;
STETZ, J ;
PAJAK, TF .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1995, 31 (05) :1341-1346
[7]   Hormone-refractory prostate cancer: a multi-step and multi-event process [J].
de la Taille, A ;
Vacherot, F ;
Salomon, L ;
Druel, C ;
de Medina, SGD ;
Abbou, C ;
Buttyan, R ;
Chopin, D .
PROSTATE CANCER AND PROSTATIC DISEASES, 2001, 4 (04) :204-212
[8]   LONG-TERM IMPACT OF CONSERVATIVE MANAGEMENT ON LOCALIZED PROSTATE-CANCER - A 20-YEAR EXPERIENCE IN JAPAN [J].
EGAWA, S ;
SHOJI, K ;
GO, M ;
UCHIDA, T ;
KUWAO, S ;
KOSHIBA, K .
UROLOGY, 1993, 42 (05) :520-526
[9]   Is α/β for prostate tumors really low? [J].
Fowler, J ;
Chappell, R ;
Ritter, M .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2001, 50 (04) :1021-1031
[10]   PI3K: Downstream AKTion blocks apoptosis [J].
Franke, TF ;
Kaplan, DR ;
Cantley, LC .
CELL, 1997, 88 (04) :435-437